Gas gangrene following sacral pressure sores

We report two cases of gas gangrene developed from sacral pressure sores. The first case was clostridial and the second, non-clostridial gas gangrene. Both patients died within two months. The first patient, a 56-year-old woman suffering from palsy of the lower half of the body for 3 weeks, developed a sacral pressure sore. One month later, crepitus by palpation and gas formation in the X-ray film were detected in the hip and right thigh. A culture of odoriferous pus yielded Clostridium limosum in addition to Staphylococcus intermedius, Enterococcus faecalis, Pseudomonas aeruginosa, and Bacteroides fragilis. Blood culture yielded Bacteroides fragilis. The patient died 50 days after admission in spite of surgical debridement and aggressive therapy with high doses of antibiotics and hyperbaric oxygen. The second patient, a 70-year-old man suffering from diabetic nephropathy, arteriosclerosis obliterans of the lower limbs, and cerebral infarction, developed a large decubitus ulcer covering the whole sacral area. Crepitus and gas were detected in the soft tissue of the left gluteal region. Almost the entire gluteus maximus muscle was necrotic. Bacteroides fragilis, methicillin-resistant or -sensitive Staphylococcus aureus and Escherichia coli were isolated from the muscle. Bacteroides fragilis was also obtained by blood culture. The patient died on the 72nd day after admission.

Endoscopic ligation of gastric varices using a detachable snare

A new technique of endoscopic treatment for gastric varices is presented here, which was applied in 10 patients, either electively (n = 9) or as emergency therapy for bleeding (n = 9) or as emergency therapy for bleeding (n = 1). A detachable snare is placed endoscopically, tightened around the varix, and then detached using a similar principle to that of band ligation. Following one or two treatment sessions (one snare applied in seven cases, two snares applied in three cases), eradication of gastric varices was observed in all patients. No significant complications were encountered, and nine of 13 snares passed spontaneously, the remaining ones being removed when found during follow-up endoscopy. Short-term follow-up (4-12 months, mean: 7.2 months) did not show either reappearance of varices or rebleeding in any of the patients. Angiography and endoscopic ultrasonography performed in four patients before and after treatment showed regression or disappearance of intramural vessels. Further studies will show the relative value of this new technique compared to other treatment modalities such as banding or cyanoacrylate injection.

The ter primordial germ cell deficiency mutation maps near Grl-1 on mouse chromosome 18

A single recessive gene, ter (teratoma), causes germ cell deficiency and a high incidence of congenital testicular teratomas in the 129/Sv-ter strain of the mouse. Linkage analyses between the ter gene and 36 marker genes of 19 chromosomes were performed with matings between the C57BL/6J-ter congenic strain and four inbred strains. Results showed that the ter gene was linked to D18Mit9, D18Mit14, and D18Mit17 on Chromosome (Chr) 18. Gene order estimated on the basis of recombination distance (in centimorgans) was [centromere-D18Mit14-5.1 (cM)-ter-0 (cM)-D18Mit17-23.8 (cM)-D18Mit9]. D18Mit17 is the microsatellite DNA of the Grl-1 (glucocorticoid receptor-1) locus. We conclude that the ter gene is closely linked to Grl-1 on Chr 18 and is a new mutation involving the developmental modification of primordial germ cells in mice.

[Clinical experience of extracorporeal life support with the use of centrifugal pump ECMO]

Many reports have documented the good results with the use of extracorporeal life support in severe respiratory and circulatory failure. In our institution, we have used the centrifugal pump (Bioconsol 540: Biomedicus Co. Ltd.) ECMO for extracorporeal life support, and obtained good results in three cases. We used V-V bypass ECMO in one case (idiopathic interstitial pneumonia) and V-A by-pass ECMO in other two cases (ARDS and meconium aspiration syndrome). Duration of total bypass in three cases were 34, 51 and 140 hours, respectively. Recent reports on the use of centrifugal pump have indicated that it can bring excellent results of circulatory assist for cardiogenic shock. Compared to the roller pump method, the use of centrifugal pump ECMO was very simple, and could serve as an effective method for providing improvement in a relatively short period.

[Regulation of aromatase in human choriocarcinoma cells]

To examine the mechanism regulating trophoblastic aromatase, we studied the effects of various agents on aromatase activity and the aromatase cytochrome P-450 (P-450arom) concentration in human choriocarcinoma JEG-3 cells. Aromatase activity was assessed by radioassay with [1 beta-3H] androstenedione. The P-450arom concentration was determined by an enzyme-linked immunosorbent assay with specific antibodies to P-450arom. Human chorionic gonadotropin (hCG) stimulated aromatase activity and increased the P-450arom concentration in a concentration-dependent (0.1-100 IU/ml) manner. Cholera toxin (CT), an adenylate cyclase activator, stimulated aromatase activity and the P-450arom concentration in a concentration-dependent (0.1-10ng/ml) and a time-dependent (12-72h) manner. 12-O-tetradecanoyl phorbol 13-acetate (TPA) (0.1-100ng/ml), a protein-kinase C activator, also stimulated aromatase activity and increased the P-450arom concentration. On the other hand, Ca2+ ionophore A23187, an agent increasing intracellular Ca2+ accumulation, inhibited aromatase activity and reduced the P-450arom concentration. The effects of CT, TPA and Ca2+ ionophore were additive. Aromatase activity was correlated with the P-450arom concentration. These results suggest that in JEG-3 cells the signal transduction system modulates aromatase activity by changing the P-450arom concentration.

Improved method for mutagenicity testing of gaseous compounds by using a gas sampling bag

A simple and safety gas exposure method was developed using a gas sampling bag as an exposure vessel and a preparation vessel of diluted gas. The gas exposure conditions such as amount of S9 in the plate, volume of gas for the plate, amount of top agar, exposure period and exposure temperature were examined by mutagenicity testing of 1,3-butadiene using the gas sampling bag. Mutagenicity tests of 14 compounds and 1,3-butadiene on S. typhimurium TA98, TA100, TA1535 and TA1537, and E. coli WP2 uvrA were also examined by the developed gas exposure method. 1,3-Butadiene, propyne (methyl acetylene), monochlorodifluoromethane, ethylchloride, diborane and silane were mutagenic. 1-Butene, 2-butene, 2-methylpropene, methyl vinyl ether, trichlorofluoromethane, dichlorodifluoromethane, 1,2-dichloro-1,1,2,2-tetrafluoroethane, 1,1-difluoroethane and phosphine were not mutagenic on S. typhimurium TA98, TA100, TA1535 and TA1537, and E. coli WP2 uvrA with or without metabolic activation. These results were compatible with a previous report, and this developed method has the advantage that it can be tested easily and safely for combustible and self-combustible substances such as 1,3-butadiene and silane.

Repair of osteochondral defects with grafts of cultured chondrocytes. Comparison of allografts and isografts

Isogeneic and allogeneic chondrocytes cultured in collagen gel were transplanted into osteochondral defects in knee joints of inbred strains of rats. At 12 weeks, all eight isografted defects had healed successfully, compared with only four of eight allografted defects (p < 0.05). At 26 and 52 weeks, all defects except one had healed successfully and there was no significant difference in the success rate between the isografted and allografted groups. Control defects that had been implanted with only collagen gel did not heal successfully.

Identification of chicken liver mitochondrial alanine:2-oxoglutarate aminotransferase and its response to starvation

In chicken liver, alanine:2-oxoglutarate aminotransferase was located only in the mitochondria. In 40-day-old chickens, starvation resulted in a dramatic increase of liver mitochondrial alanine:2-oxoglutarate aminotransferase activity, reaching about a 100-fold increase in the activity (units/g of liver) on Day 7 of starvation. The mitochondrial alanine:2-oxoglutarate aminotransferase was purified to homogeneity and characterized from the mitochondrial extract of 7-day-starved chicken liver. The enzyme possessed alanine:glyoxylate aminotransferase activity and was also present in control chicken liver. The enzyme was found in the present study for the first time and named alanine:2-oxoglutarate (glyoxylate) aminotransferase. Alanine:2-oxoglutarate aminotransferase specific for alanine and 2-oxoglutarate as substrates was not detected in both control and starved chicken livers. In contrast, liver mitochondrial alanine:2-oxoglutarate aminotransferase from mammals did not possess alanine:glyoxylate aminotransferase activity. The increase in mitochondrial alanine:2-oxoglutarate aminotransferase activity during starvation was found to be attributed to an increase in enzyme protein.

Immunohistochemical localization of neural visinin-like Ca(2+)-binding protein 2 in adult rat brain

The distribution of neural visinin-like Ca(2+)-binding protein 2 (NVP2) in adult rat brain was analyzed by immunoblot and immunohistochemical methods. NVP2 immunoreactivity was expressed intensely in the pyramidal cells of the CA1 and 2 regions of Ammon's horn, the granule cells of the dentate gyrus and the pyramidal cells of the cerebral cortex layers II to VI, moderately in the pyramidal-shaped cells of the anterior olfactory nucleus and large spindle-shaped cells of the globus pallidus, and weakly in neurons in the nucleus accumbens and the anterior and dorsomedial thalamus. In most cell types, NVP2 immunoreactivity was located in the cytoplasm and plasma membrane of the cell bodies and dendrites.

Amphibian allantoinase. Molecular cloning, tissue distribution, and functional expression

The chain of enzymes necessary to convert uric acid to its metabolic products urea and glyoxylic acid in vertebrates is truncated through the successive loss of allantoicase, allantoinase, and urate oxidase during phylogenetic evolution. Previous studies have assigned the localization of both urate oxidase and allantinase to the peroxisome in the amphibian liver. This study reports the cloning of a cDNA encoding bullfrog (Rana catesbeiana) allantoinase, an enzyme that converts allantoin to allantoic acid. The cDNA is 2112 base pairs in length containing a 1449-base pair open reading frame which corresponds to a 483-residue protein (53,296 Da). Structural analysis of the deduced protein suggested two potential transmembrane segments and the presence of a putative mitochondrial localization sequence in the amino terminus. Immunocytochemical analysis revealed that allantoinase is localized to mitochondria and not to peroxisomes. On Northern blotting, a single mRNA species was detected in the liver and kidney of frog but not in other tissues; this distribution was confirmed by immunoblotting. The hepatic- and renal-specific expression of allantoinase coincides with the distribution of urate oxidase in these tissues in the frog. The allantoinase expressed in Saccharomyces cerevisiae and in Spodoptera frugiperda (Sf9) insect cells exhibits catalytic activity and is antigenically identical to the native frog enzyme.

Insulin stimulates the phosphorylation of Tyr538 and the catalytic activity of PTP1C, a protein tyrosine phosphatase with Src homology-2 domains

PTP1C is a non-transmembrane protein-tyrosine phosphatase and contains two Src homology-2 (SH2) domains. Insulin stimulated the tyrosine phosphorylation of PTP1C in human 1M-9 lymphoblast cells, in rat H35 hepatoma cells and in Chinese hamster ovary cells over-expressing both insulin receptors and PTP1C. Insulin also stimulated the tyrosine phosphorylation of a mutant PTP1C lacking SH2 domains in Chinese hamster ovary cells, suggesting that the SH2 domains are not required for insulin-stimulated tyrosine phosphorylation of PTP1C. The insulin receptor tyrosine kinase catalyzed the tyrosine phosphorylation of PTP1C in a cell-free system. Peptide mapping of phosphorylated PTP1C showed that Tyr538 in the C-terminal region was phosphorylated in response to insulin. The tyrosine phosphorylation of PTP1C by the insulin receptor kinase increased phosphatase activity. Furthermore, PTP1C was shown to bind to autophosphorylated insulin receptors through its C-terminal region, but PTP1C did not bind to unphosphorylated receptors. These results suggest that PTP1C is a target protein for the insulin receptor tyrosine kinase and that the C-terminal region of PTP1C may function both in the regulation of phosphatase activity and in the association of PTP1C with autophosphorylated insulin receptors.

Molecular cloning of human hippocalcin cDNA and chromosomal mapping of its gene

We have isolated a cDNA clone encoding human hippocalcin from a human hippocampus cDNA library. This clone (hHLP1) consists of 840 nucleotides, including the entire open reading frame of 582 nucleotides, 10 nucleotides of the 5' leader and 248 nucleotides of the 3' noncoding regions. Comparison of the human hippocalcin sequence with the corresponding rat sequence revealed an amino acid identity of 100% and nucleotide identity of 92%. Northern blot analysis showed that a single transcript at a position corresponding to 2.0 kb was detected only in the brain. The human hippocalcin gene was mapped to chromosome 1 by amplification of human hippocalcin-specific DNA fragment on DNA from human-rodent somatic cell hybrids by using the polymerase chain reaction.

Uric acid degrading enzymes, urate oxidase and allantoinase, are associated with different subcellular organelles in frog liver and kidney

On the basis of differential and density gradient centrifugation studies, the site of the uric acid degrading enzymes, urate oxidase and allantoinase, in amphibia was previously assigned to the hepatic peroxisomes. Using specific antibodies against frog urate oxidase and allantoinase, we have undertaken an immunocytochemical study of the localization of these two proteins in frog liver and kidney, and demonstrate that whereas urate oxidase is present in peroxisomes, allantoinase is localized in mitochondria. Urate oxidase and allantoinase were detected by immunoblot analysis in both frog liver and kidney. The subcellular localization of these two enzymes was ascertained by Protein A-gold immunocytochemical staining of Lowicryl K4M-embedded tissue. Peroxisomes in frog liver parenchymal cells and kidney proximal tubular epithelium contained a semi-dense subcrystalloid core, which was found to be the exclusive site of urate oxidase localization. Allantoinase was detected within mitochondria, but not in peroxisomes of hepatocytes or proximal tubular epithelium. No allantoinase was detected in the mitochondria of nonhepatic parenchymal cells in liver and of the cells lining the distal convoluted tubules of the kidney. These results demonstrate that, unlike rat kidney peroxisomes which lack urate oxidase, peroxisomes of frog kidney contain this enzyme. Contrary to previous assumptions, these studies also clearly establish that urate oxidase and allantoinase, the first two enzymes involved in uric acid degradation, are localized in different subcellular organelles in frog liver and kidney.

Liver function tests of recipients with hepatitis C virus infection after bone marrow transplantation

We used the polymerase chain reaction (PCR) to determine the presence of hepatitis C virus (HCV)-RNA in serum samples obtained from 19 patients with leukaemia or severe aplastic anaemia and investigated the correlation between HCV status and the results of liver function tests after bone marrow transplantation. PCR analysis of serum samples obtained before transplant showed that 10 of 18 patients were HCV-RNA-positive; 5 of these patients had developed acute post-transfusion hepatitis 1-11 months before transplant. An additional patient was HCV-RNA-positive on post-transplant day 62. Eight HCV-RNA-positive patients had pre-transplant GPT levels above the upper limit of normal. In these patients the GPT decreased significantly from a median of 104 IU/l (54-822 IU/l) pre-transplant to 23 IU/l (15-56 IU/l) on post-transplant days 8-12. In 9 of 11 HCV-RNA-positive patients, the GPT increased transiently from days 40 to 50 and again increased after day 100. Two of these patients died from hepatic failure; the GPT levels normalised in 3 patients after day 300 but continued to fluctuate in 4 patients. In the remaining 2 HCV-RNA-positive patients, the GPT remained close to the normal range throughout the follow-up period. Three HCV-RNA-positive patients became HCV-RNA-negative after 1-3 years. In these patients, the GPT remained normal for > 3 years after day 300.(ABSTRACT TRUNCATED AT 250 WORDS)

Biotransformation of (+)-camphor by cultured cells of Eucalyptus perriniana

Seven new biotransformation products were isolated from a jar fermentor culture of Eucalyptus perriniana following administration of (+)-camphor. The main product was (1S,4R,6S)-6-hydroxybornan-2-one 6-O-beta-D-glucopyranoside. The minor components were (1S,4R,6R)-6-hydroxybornan-2-one 6-O-beta-D-glucopyranoside, (1R,4S,6S)-6-hydroxybornan-2-one 6-O-beta-D-glucopyranoside, (1R,4R,5R)-5-hydroxybornan-2-one 5-O-beta-D-glucopyranoside, (1R,3R,4S)-3-hydroxybornan-2-one 3-O-beta-D-glucopyranoside, (1R,4R,7R)-8-hydroxybornan-2-one 8-O-beta-D-glucopyranoside and 2-(4-oxo-2,2,3-trimethylcyclopentyl)-ethyl-beta-D-glucopyranoside. All products were mono-glucosides and the oxygen function was introduced before glucosylation. Reduction of the ketone group of camphor was not observed.

Transcriptional regulatory regions for expression of the rat pyruvate kinase M gene

To study the regulatory mechanism of pyruvate kinase M gene transcription, we analyzed its chromatin structure and cis-acting DNA regions. Two DNase-I-hypersensitive sites were detected in dRLh-84 hepatoma cells, but not in hepatocytes, which coincides with expression of the M gene in the two types of cells. These sites, designated HS2 and HS1, were located around the major transcription start site and about 2.9 kb downstream from this site, respectively. A transient chloramphenicol acetyltransferase expression assay indicated that the region around HS1 did not show any activity, whereas the upstream region up to -457 had promoter activity in hepatoma cells. Most of this activity was lost by a 5'-deletion from -286 to -225. Further analysis identified a cluster of three cis-acting regions from -279 to -216, which are named boxes A, B and C. These regions did not have any independent effect, but the inclusion of all regions were synergistic. These regions were not active in hepatocytes, suggesting that they have cell-type specificity. A gel mobility shift assay indicated that unidentified, but distinct, nuclear proteins bound to the three boxes. These results suggest that transcriptional regulation of the M gene involves alteration of chromatin structure and binding of proteins to three cis-acting elements.

A survey of spinal cord injuries resulting from sport

We surveyed 35 patients who had been admitted to the Hakone National Hospital with a traumatic spinal cord injury (SCI) resulting from sports accidents, from 1975 to 1991. There were 32 males and three females. Thirty-one patients (88.6%) under the age of 30 had been injured. The most common sport was swimming (51.4%), followed by gymnastics (22.8%). The most common factors were conceit and lack of skill. The injuries were predominantly at the C4-5-6 level. Thirty-four of the patients had a cervical spine injury. Paralysis at the sixth cervical level occurred in 15 cases. Regarding the mechanism of injury, impact on the ground due to misjudgment in the depth of water was the most frequent in swimming; and failure in a somersault the most frequent in gymnastics. The most important point raised in the prevention of SCI sport was education about the dangers during elementary schooling.

The GARP gene encodes a new member of the family of leucine-rich repeat-containing proteins

We have characterized a new human gene, named GARP, localized in the 11q14 chromosomal region. GARP comprises two coding exons, is expressed as two major transcripts of 4.4 and 2.8 kilobases, respectively, and encodes a putative transmembrane protein of 662 amino acids, the extracellular portion of which is almost entirely made of leucine-rich repeats. The molecular weight of the protein immunoprecipitated from transfected cells is 80,000. The GARP protein has structural similarities with the human GP Ib alpha and GP V platelet proteins, and with the Chaoptin, Toll, and Connectin adhesion molecules of Drosophila.

Occurrence of carbamoyl-N-hydroxy derivatives of saxitoxin and neosaxitoxin in a xanthid crab Zosimus aeneus

Two novel paralytic toxins were isolated from toxic specimens of a xanthid crab Zosimus aeneus inhabiting Ishigaki Island, Okinawa. The structures of two of these were deduced to be carbamoyl-N-hydroxysaxitoxin and carbamoyl-N-hydroxyneosaxitoxin based on electrophoresis, high performance liquid chromatography, electrospray ionization mass spectrometry, 1H NMR, 13C NMR and conversion experiments. They showed specific toxicities of 1700 and 1400 mouse units per mg on i.p. injection into mice.